Most Relevant Information
Provider Data
| NPI Number: | 1003347964 |
| Provider Name: | GABRIELLE MAVELIAN DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/22/2017 |
| Last Updated: | 12/02/2020 |
Provider Practice Location
5450 CLEARFORK MAIN ST STE 300
FORT WORTH
TX
761093514
Practice Location Phone/Fax
| Phone: | 8173341400 |
| Fax: | 8173341410 |
Provider Mailing Location
5450 CLEARFORK MAIN ST STE 300
FORT WORTH
TX
761093514
Provider Mailing Phone/Fax
| Phone: | 8173341400 |
| Fax: | 8173341410 |